The effectiveness of gambling exclusion programs in Queensland

Transcription

1 The effectiveness of gambling exclusion programs in Queensland Nerilee Hing, Barry Tolchard, Elaine Nuske, Alex Russell This study was funded by a Responsible Gambling Research Grant from the Queensland Department of Justice and Attorney General National Association for Gambling Studies Conference, November 2014

2 Background Gambling operators in QLD: must provide SE procedures have authority but not duty to initiate venue exclusions ~ 5,800 active SEs in QLD Jan-Jun 2013: SEs by 42% hotels, 25% clubs, casinos, Tattsbet SEs by 628 gamblers = 320 (hotels), 171 (casinos), 125 (clubs), 12 (Tattsbet) 5 venue-initiated exclusions

3 Research objectives Assess the effectiveness of Qld gambling exclusion programs as a mechanism to minimise gambling-related harm Determine whether these effects are sustained over time Assess whether exclusion is more effective when combined with counselling and support

4 Methods 1. Interviews with peak body reps (N = 4) QHA, Clubs Qld, Tattsbet, Echo 2. Interviews with gambling counsellors (N = 18) Representing all but 1 Qld GHS agencies Client experiences & counsellors professional views on SE 3. Surveys & interviews with 103 problem gamblers Group A: SE + counselling = 34 Group B: SE no counselling = 19 Group C: No SE + counselling = 33 Group D: No SE no counselling = 17 Interviewed and surveyed 3 times about 6 months apart Group D not a valid control at T1 Groups A-C, 78% retained at T2, 59% at T3

5 Measures Quantitative: SE details if applicable, gambling frequency, expenditure & debt, most problematic form, perceived PG severity, PGSI, Gambling Urge Scale, CAGE, GHQ12, Gambling Consequences Scale, use of professional, non-professional and self-help, demographics Qualitative: Motivators, barriers, experiences during SE process, outcomes, suggested improvements Professional gambling help, whether coincided with, prompted and/or supported SE, reasons for not seeking counselling if applicable Other supports used, how they assisted SE or not What had been most effective

6 Q1: Does SE minimise gamblingrelated harm? Are effects sustained? Surveys revealed significant improvements: on nearly all outcome measures after SE abstinence, expend., debt, perceived problem, PGSI, urge, general health & harmful consequences occurred soon after SE, by first 6 mths of assessment sustained, on average, for 12 mths of assessment Confirmed by qualitative interviews with excluders: reduced gambling, greater control, strategies to resist urges, reduced stress & anxiety, improved self-esteem & physical health, reduced harms e.g, finances, relationships, work, health, wellbeing Aligns with counsellors general view of SE as an external control which can have immediate benefits while build up internal control

7 Q2: Does SE minimise gambling harm, more than counselling alone? Improvements after SE do not show that SE causes these improvements Thus, compared outcome measures between: Self-excluders (with and without counselling) Non-excluders (with counselling)

8 Both excluders and non-excluders significantly improved equally on the following outcomes

9 Monthly gambling expenditure ($) 2,500 2,361 2,000 1,500 1,477 1, , Non-

10 Gambling debt ($) 20,000 18,000 16,000 14,000 12,000 10,000 8,000 6,000 4,000 2, ,636 12,205 7,547 3,249 1, Non-

11 Perceived severity of gambling problem (1= not at all, to 10 = extremely severe) Non-

12 Mean PGSI score Non-

13 Mean gambling urge score Non-

14 Mean General Health Questionnaire score Non-

15 % reporting that their gambling had left them with no money to pay for household bills Non-

16 % reporting that their gambling had made it harder to make money last from one payday (or pension day) to the next Non-

17 % reporting that because of their gambling people close to them had difficulties trusting them Non-

18 SE group showed significantly greater improvements on the following outcomes

19 % of respondents reporting abstaining from most problematic gambling form Non-

20 % reporting that their gambling had left not enough time to look after family interests Non-

21 % reporting that their gambling had impacted negatively on relationship with children Non-

22 % reporting that their gambling had caused them to put off doing things together Non-

23 % reporting that their gambling had affected their performance in their work, study or main role Non-

24 % reporting that their gambling had caused them to lose time from work, study or main role Non-

25 % reporting that their gambling had left them no money to pay their rent or mortgage Non-

26 Q3: Is SE more effective when combined with counselling & other supports? Compared: Excluders who had received counselling Excluders who had not received counselling No significant differences found in any outcome measures for these 2 groups BUT, small numbers Qualitative data suggested counselling with SE had numerous benefits for most who had received counselling

27 Benefits of counselling with SE Raise awareness, influence decision to, and assist with SE Achieve long-term benefits and relapse prevention through resolving underlying problems Participants found counselling very useful to: understand underlying reasons for gambling address gambling and wider life problems devise practical strategies to control gambling build up internal control. Gamblers overwhelmingly believed that a combination of interventions, supports and self-help was most effective for them, including SE

28 Summary of findings Q1: Does SE minimise gambling-related harm? Are effects sustained? SE associated with significantly reduced problem gambling symptoms & reduced harmful consequences Most improvements happen quickly & sustained for 12 mths Q2: Does SE minimise gambling harm, more than counselling alone? No for most measures, but evidence that SE increases abstinence from most problematic form & reduces some harmful consequences more than counselling alone, at least in short term Q3: Is SE more effective when combined with counselling & other supports? No evidence from quant. data, but qual. data suggested counselling with SE had numerous benefits

29 Conclusions Given low rates of professional help-seeking, SE provides an important harm minimisation alternative to counselling with at least short-term benefits for many participants Process evaluation showed that uptake of SE could be vastly improved by facilitating access & lowering barriers More uptake of counselling would assist uptake of SE Providing a wide range of supports important to assist gamblers to access those they find most useful

30 Limitations & strengths of the study Limitations Modest sample sizes limited analyses Could only compare SE to non-se + counselling Were those retained different from those who dropped out? Self-report, retrospective, social desirability Strengths 1 st independent evaluation Informs potential improvements in SE programs 1 st Aust. longitudinal study of role of SE in harm minimisation And of counselling and other supports as adjuncts to SE Further research Bigger samples, longer timeframes And into multi-venue programs and online SE programs

31 Hing, N., Tolchard, E., Nuske, E., & Russell, A. (2014). The effectiveness of self-exclusion programs in Queensland. Brisbane: Qld Department of Justice and Attorney-General.